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. 2018 May 8;18(1):28.
doi: 10.1186/s12911-018-0605-y.

The relationship between hospital and ehr vendor market dynamics on health information organization presence and participation

Sunny C Lin  1 , Julia Adler-Milstein  2
Affiliations

The relationship between hospital and ehr vendor market dynamics on health information organization presence and participation

Sunny C Lin et al. BMC Med Inform Decis Mak. .

Abstract

Background: Health Information Organizations (HIOs) are third party organizations that facilitate electronic health information exchange (HIE) between providers in a geographic area. Despite benefits from HIE, HIOs have struggled to form and subsequently gain broad provider participation. We sought to assess whether market-level hospital and EHR vendor dynamics are associated with presence and level of hospital participation in HIOs.

Methods: 2014 data on 4523 hospitals and their EHR vendors were aggregated to the market level. We used multivariate OLS regression to analyze the relationship between hospital and vendor dynamics and (1) probability of HIO presence and (2) percent of hospitals participating in an HIO.

Results: 298 of 469 markets (64%) had HIO presence, and in those markets, 47% of hospitals participated in an HIO on average. In multivariate analysis, four characteristics were associated with HIO presence. Markets with more hospitals, markets with more EHR vendors, and markets with an EHR vendor-led HIE approach were more likely to have an HIO. Compared to markets with low hospital competition, markets with high hospital competition had a 25 percentage point lower probability of HIO presence. Two characteristics were associated with level of hospital HIO participation. Markets with more hospitals as well as markets with high vendor competition (compared to low competition) had lower participation.

Conclusion: Both hospital and EHR vendor dynamics are associated with whether a market has an HIO as well as the level of hospital participation in HIOs.

Keywords: Electronic health records; Health information exchange; Systems integration.

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Conflict of interest statement

Ethics approval and consent to participate

This research did not involve human subjects, human material, or human data, and therefore did not require ethics approval or consent to participate. The authors did not seek ethics approval or consent to access the data used in this study.

Consent for publication

This manuscript did not contain details, images, or videos relating to an individual person, therefore written informed consent for publication was not required.

Competing interests

The authors declare that they have no competing interests.

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